20 minute read
5.2 Specific Technical Area Recommendations
Advertisement
The following recommendations are specific to each of PAHO’s technical departments. Please click the headings below to navigate to a specific category of recommendations.
DEPARTMENT
1. Communication in Health
5. Family and Life Course, Health Promotion, Workers’ Health, and Immunization General
6. Evidence, Information Systems, Knowledge Management, and Information Health Information and Analysis
7. Health Systems and Services, Universal Health Coverage, Research, Nursing, and Bioethics General TECHNICAL AREA
Environmental Health Neglected Tropical Diseases and Zoonoses Tuberculosis Chagas Disease and Insecticide Use Antimicrobial Resistance Health Risk Assessment
Mental Health/ Disabilities Violence Prevention Alcohol/ Tobacco/ Substances
Worker’s Health Maternal and Newborn Health
Digital Health and Misinformation Family of International Classification
Medicines and Health Technologies Human Resources for Health Health Promotion Housing
Knowledge Management and Translation
Healthcare Quality and Patient Safety Health Expenditure
1. Communication in Health
• Continue to strengthen response to the COVID-19 pandemic through health communications.
• Identify technical gaps and training actions, and develop materials that function as communication work guides.
• Conduct research on strategic communication management and digital communicative production that can be promoted in prioritized spaces, with the participation of students.
• Explore with CCs ways to provide creative solutions to enhance PAHO/WHO technical cooperation.
• Explore opportunities within PAHO for students/consultants outside of the CC partnership.
General
• Identify gaps where CCs can contribute to addressing diseases under PAHO’s Disease Elimination Initiative.
Environmental Health
• Identify gaps where CCs can contribute to addressing diseases under PAHO’s Disease Elimination Initiative.
• Develop a network for CCs and other key institutional partners doing measurement and monitoring of environmental risks in the areas of air pollution or chemical safety, climate change and extreme weather events.
• Engage networks of CCs in the work being done to eliminate open defecation and the use of solid fuels for cooking in the Region. • Conduct inter-programmatic work among CCs in the Climate and Environmental Determinants of Health Unit focused on: (a) strengthening surveillance; (b) integrating environmental public health surveillance systems; and (c) strengthening human resources in the area of environmental public health and climate change.
• Produce molecularly imprinted polymers (MIPs) in large scale and use them as highly selective materials for the removal of emerging pollutants from wastewater.
• Apply the ability of MIPs to extract degradation metabolites of the molecules under study through the O3/UV/MIP system.
• Implement new extraction and degradation technologies in wastewater treatment processes.
• Develop and apply materials selective to emerging contaminants/endocrine disruptors and degradation products that reduce their toxicity in human and animal organisms.
<< BACK TO
• Propose public policies focused on: (a) establishing legislation for unregulated emerging pollutants; (b) reducing the use of raw materials for detergents that use endocrine disruptors; and (c) monitoring and controlling sources of contamination and modification of standards for permitted levels of mycotoxins in food.
• Develop and implement programs focused on: (a) biomonitoring of exposure to contaminants in communities highly exposed to mycotoxins; (b) the control of sources of contamination; and (c) community strategies for the correct management of crops and food to avoid and reduce mycotoxin contamination.
• Develop renal health monitoring programs focused on the early detection of renal damage to prevent its progression and study the environmental risk factors for renal disease.
• Promote the involvement of the health sector in the development of tools and training opportunities in health and environment.
• Strengthen research capabilities in the prevention of environmental risks and mitigation of their impact on public health.
• Generate regional platforms for teaching, learning, and sharing knowledge on identification and prevention activities related to air pollution and chemical safety.
Neglected Tropical Diseases and Zoonoses
• Establish a community of practice for program managers involved in managing large scale deworming programs.
• Ensure that national health plans have health policies in place to support the planning, implementation, and monitoring of prevention and control programs for all neglected tropical diseases, including soil-transmitted helminthiases.
• Advocate for integrated activities for the prevention and control of neglected tropical diseases and other communicable diseases, whenever possible, to optimize financial and human resources.
• Promote the implementation and use of mHealth tools, such as mobile applications, to follow up patients in dispersed rural areas.
• Strengthen the multidisciplinary approach to viral zoonoses.
• Promote the research and development of vaccines and strategic biologics in the field of viral and emerging zoonoses, particularly for neglected diseases.
Tuberculosis
• Support and follow up on the development of plans and strategies to improve the structure and performance of the TB component of the National Health Information Systems.
• Support countries in the TB information production process, which includes data processing and analysis, and the dissemination of TB information at the national level.
• Support and monitor the uploading of information to the WHO global TB data collection system to improve the coverage and quality of the data provided by the Region’s Member States.
• Support the execution of epidemiological TB reviews (EPI Reviews) and the training of TB teams in the analysis of strategic information for TB.
Chagas Disease and Insecticide Use
• Encourage countries to achieve/sustain the interruption of household vector-borne transmission of Trypanosoma cruzi in all their geographic areas, in accordance with PAHO recommendations.
• Deepen the knowledge, mapping, and management of insecticide resistant phenomena with the support of specialized institutions.
• Continue evaluating the effectiveness of new insecticides and the development of new formulations for vector control and increase the training of personnel in Argentina and the Region.
<< BACK TO
5.2 SPECIFIC TECHNICAL AREA RECOMMENDATIONS
Antimicrobial Resistance
• Enhance surveillance of antimicrobial resistance (AMR).
• Develop an understanding of the determinants of outpatient and inpatient antimicrobial use in Member States.
• Continue to monitor and evaluate potential emerging pathogens to ensure healthy lives and promote the well-being of people at all ages.
• Develop and implement educational programs regarding antimicrobial use with adaptation to individual venues.
• Optimize national programs related to AMR.
• Foster collaboration among Member States in responding to pandemics due to AMR.
• Ensure control of antimicrobial use in animals and the environment.
• Work with institutions to develop AMR surveillance programs in the sectors of agriculture, health, and environment in Latin American nations, support the implementation of such programs, and promote the exchange of information about AMR among Member States.
Health Risk Assessment
• Research and implement population screening strategies for the timely detection of infectious diseases that are lowcost, simple, fast, mobile, accessible, sensitive, and specific. Research on screening models should be conducted in different sociodemographic populations and in collaboration with CCs.
• Propose public policies for the development of innovation-based screening methods.
• Apply screening models for the evaluation and monitoring of infectious diseases (e.g., COVID-19) and their progression in communities with limited access to health services.
General
• Prioritize the prevention of noncommunicable diseases within PAHO, and capitalize on the capabilities of CCs to produce and use relevant data.
• Use the model developed for the Social Marketing in Public Health online curriculum and tutorized instruction for other important topic areas.
Mental Health/Disabilities
• Plan appropriate monitoring and surveillance systems, including timely reporting of, at a minimum, age and sex-disaggregated data to relevant sources, and periodic analysis of local data to inform on-going activities. When possible, disaggregate data, in all areas, by the existence of disability and disabling health conditions to help monitor the living and health conditions of these populations.
• Promote inclusive and accessible health care, teaching, and research for people with disabilities and disabling health conditions.
• Sensitize politicians to the existing problems associated with epilepsy and its consequences.
• Promote communication campaigns for the use of inclusive language around epilepsy (e.g., person with epilepsy instead of epileptic).
• Create policies on epilepsy education for schoolchildren, teachers, and university students, particularly those in health and education fields.
• Develop national suicide prevention programs, especially in countries with higher suicide rates. National systemic evaluation of available epidemiologic data, including risk factors, is an essential tool for suicide prevention programs.
• Strengthen information systems and surveillance of suicidal behavior, develop registries of suicidal behavior, and implement follow up mechanisms in high-risk cases.
<< BACK TO
• Prioritize mental health at the national level across the Region and implement verifiable quality indicators to demonstrate progress.
Violence Prevention
• Articulate, in an intersectoral network, actions to prevent and respond to violence against children and adolescents.
• Invest in strengthening the system for reporting violence against children, by all institutions of the Rights Guarantee
System, with an emphasis on the channels for reporting violations against various vulnerable groups (e.g., Dial 100), and the laws that mandate disclosure of data and information on human rights.
• Design school programs and interventions to reduce disorder and improve relationships between students, teachers, and staff, with the goal of recovering the school climate and spaces of freedom and autonomy.
• Implement interventions that target the entire school population, along with programs focused on adolescents in situations of social vulnerability and on those at high risk of developing violent behavior and/or being victimized by violence.
• Identify the main issues in the school environment that create dangerous environments for children as a starting point for advocacy, and establish partnerships between schools and health units.
• Support teachers and health agents, as they are essential for preventing violence against children and adolescents.
Alcohol/Tobacco/ Substances
• Promote the improvement and expansion of country-level surveillance systems for alcohol use and resulting harms.
• Investigate new interventions (e.g., labeling) that may reduce harmful alcohol use.
• Monitor novel tobacco product policies (E-cigarette Policy Scan 19 & Heated Tobacco Product Policy Scan 20).
• Provide training to build tobacco control capacity (Suite of Online Courses 21).
19 Institute for Global Tobacco Control. Country Laws Regulating E-cigarettes: A Policy Scan [Internet]. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health; 2020 Dec. Available from: https://www.globaltobaccocontrol.org/e-cigarette_policyscan. 20 Institute for Global Tobacco Control. Countries That Regulate Heated Tobacco [Internet]. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health; 2020 Dec. Available from: https://globaltobaccocontrol.org/resources/countries-regulate-heated-tobacco. 21 Institute for Global Tobacco Control. Online Courses [Internet]. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health. Available from: https://www.globaltobaccocontrol.org/content/online-courses.
• Conduct confirmatory analyses if saliva testing for substance use is implemented as a surveillance tool in the ER setting.
• Conduct studies throughout the Region on alcohol use in combination with other drugs by drivers, passengers, and pedestrians to determine, at the regional level, the risk of road traffic injuries from alcohol and other drug use, especially cannabis.
5. Family and Life Course, Health Promotion, Workers’ Health and Immunization
General
• Engage CCs with civil society organizations and other nongovernmental organizations to carry out public health interventions for vulnerable populations.
Worker’s Health
• Promote the work of CCs related to workers’ health as it could be useful to CCs working on other topics.
• Measure and surveil exposure levels to radon, and its progenies, in workplaces. Doing so would contribute to the implementation of occupational exposure control measures to prevent related diseases (especially lung cancer).
• Establish health policies and criteria for managing the risk of radon exposure in work environments, appropriate to national conditions.
• Promote interaction among the CCs working in occupational health to enable the effective incorporation of the
Participatory Ergonomics methodology into the work environments of the Region’s Member States. A participatory ergonomic intervention in the workplace involves developing a program tailored to the needs and possibilities of the organization, considering not only the technical and methodological aspects, but also the commitment of all those involved.
• Collect experiences and good practices in Participatory Ergonomics, and compile information on the Participatory
Ergonomics model applied in work environments in the Member States of the Region. From the compiled data, analyze the factors that facilitate and hinder the application of the model. • Increase occupational safety and Health (OSH) expertise globally, by: (a) partnering with employers (e.g., private & multinational companies, governments, nongovernmental organizations, and labor unions) to enhance OSH expertise among their workforces; (b) identifying funding sources to offer more scholarships for the Global Program in Occupational Health & Hygiene Practice (GPOHP); (c) collaborating with other CCs to offer instruction in various languages; (d) developing networks among prior GPOHP participants to continue lifelong learning and advancing skills; and (e) developing higher level GPOHP courses to continue advancing skills and improving competence.
Maternal and Newborn Health
• Officialize the World Human Milk Donation Day on 19 May within WHO.
• Develop virtual courses to scale up competency-based education and training for the midwifery workforce.
Health Promotion
• Translate the Virtual Course on Health Promotion into Portuguese and Spanis hand make the course available globally.
Housing
• Integrate housing and urban health variables into the research of other CCs.
• Adapt the Healthy Housing Guide to the current Regional context.
• Develop an evidence-based toolkit to enable the implementation of the WHO’s housing and health guidelines.
<< BACK TO
5.2 SPECIFIC TECHNICAL AREA RECOMMENDATIONS
6. Evidence, Information Systems, Knowledge Management, and Information
Health Information and Analysis
• Identify gaps to accessing health information.
• Support the strengthening of vital and health statistics systems in Member States.
• Increase attention to information system development and sharing, including practical measures to promote the use of standardized definitions and compatible processes.
• Strengthen the governance mechanisms of information systems, so that countries can make decisions based on health data with the highest possible level of disaggregation.
• Improve capacity to interpret data to allow for a better understanding of local situations.
• Use the data provided by national authorities and what is known about the social determinants of health to address public health issues.
• Strengthen information systems to allow for timely notifications, alerts, and responses to health events of national and international interest.
• Support the process of implementing the disability certificate in Mexico.
• Embrace new technologies, data sources, and methods to supplement traditional public health epidemiology, and establish clear, ethical, regulatory, and open policies for use of these new approaches.
• Train public health workers in basic data science concepts and methods.
<< BACK TO
5.2 SPECIFIC TECHNICAL AREA RECOMMENDATIONS
Digital Health and Misinformation
• Strengthen the capacities of health sector workers in the field of digital health.
• Ensure risk communications are agile and flexible, and engage the local community.
• Help public health professionals understand how false information appeals to people and which countermeasures are effective.
• Understand how the methods people use to find and interact with information differ by demographic needs.
• Renew or develop regulatory instruments that facilitate the exchange of personal data, while protecting the identity of individuals and any other sensitive information.
Family of International Classifications
• Use the International Classification of Diseases 11th Revision (ICD-11) to create indicators for the achievement of the
SDGs.
• Increase awareness and knowledge of the ICD-11 among CCs and involve them in its implementation process.
• Continue to support collaborative activities between countries focused on the application of the Family of International
Classifications (training courses, discussion forums, etc.).
• Support the ICD-11 dissemination process in Mexico to help develop the necessary experience and promote its use in the Region’s Member States.
• Support the work of codifiers in the Region, and make their work more visible.
• Maintain technical and logistical collaboration between the Dirección General de Información en Salud (DGIS) /
Centro Mexicano para la Clasificación de Enfermedades and PAHO/WHO.
Knowledge Management and Translation
• Translate CCs’ research articles into policy briefs, lay summaries, and/or other communication products that are more accessible to the public.
• Share the knowledge management practices implemented by CCs during the COVID-19 pandemic.
• Link health sciences research in the Region to the Open Science processes.
• Hold an annual regional workshop on scientific publication (based on the Cuban experience of the PUBLICIENT event (http://publicient.sld.cu/index.php/publicient/%202021).22
• Encourage CCs with expertise in dissemination/knowledge translation to support other CCs with less expertise.
• Integrate the development of health information literacy into a regional network, based on a contextualized frame of reference. • Contribute to the development of institutional policies and the design of health care processes for the promotion of safe health care in the Region and among WHO Member States.
7. Health Systems and Services, Universal Health Coverage, Research, Nursing, and Bioethics
General
• Foster the development of advanced practice and evidence-based care throughout the Region.
• Capitalize on the unique opportunities for educational quality improvement through interprofessional learning and collaboration that the postpandemic era offers.
Medicines and Health Technologies
• Evaluate the success of nonpharmacological strategies for the prevention of infection in communities.
• Provide training on the components of the National Pharmaceutical Policy to strengthen pharmaceutical assistance and access to medicines in Brazil.
• Establish a definition of medicine shortages, monitor medicine shortages, increase communication/dissemination activities, and carry out regulatory actions to curb commercial practices that may harm public health.
• Strengthen the collaboration between countries to promote the utilization of health technology assessment (HTAs) in health decision-making.
• Link the HTA community and institutions with the Clinical Practice Guidelines to ensure harmonization between the recommendations in both areas and reports.
• Avoid the duplication of work between different countries with regards to the evaluation of technologies. • Articulate the principles, objectives, and strategies of patient safety to the surveillance and control agencies of the health system in Mexico, and in other PAHO and WHO Member States.
Human Resources for Health
• Integrate policy appreciation of health equity concerns in human resources (e.g. Health workers), economic planning, and decision-making.
• Strengthen the training of human resources to build capacity in the deployment of CC activities.
• Focus on purposeful partnering within the Academic Nursing Service-Learning Partnerships, which play a critical role towards meeting the PAHO objective of universal access to health and universal health coverage. Cultural adaptation of tools and further research are required when rolling out collaborative partnerships in Latin America and the
Caribbean based on assumptions/tools derived mostly from the North American experience.
• Consider the health workforce environment when promoting Universal Health Coverage, especially in the context of
COVID-19.
• Strengthen nursing research capacity focused on safe and equitable care with positive outcomes.
• Support increases in nursing care capacity and quality through best practices in curriculum, testing, registration, licensing, and continuing education.
• Develop nursing leadership for the important contributions nurse leaders make to healthcare delivery systems, research, and public health policy.
Healthcare Quality and Patient Safety
• Strengthen the network of CCs that have topics of interest related to patient safety to establish interinstitutional and multisectoral actions.
• Develop programs to cultivate an emphasis on research, healthcare quality, and patient safety.
22 publiCIENT. VII Taller Nacional de Publicación Científica en Ciencias de la Salud [Internet]. La Habana, Cuba: infoMED; 2021. Available at: http://publicient.sld.cu/index.php/publicient/%202021. << BACK TO
5.2 SPECIFIC TECHNICAL AREA RECOMMENDATIONS
Health Expenditure
• Build regional capacity in the use of: (a) the System of Health Accounts 2011 tool to track the flow of expenditure throughout the health sector; (b) the Health Financing Matrix; and (c) the Health Protection Indicators, to facilitate effective monitoring and evaluation.
• Assess health financing arrangements in the Region to determine the need for reform.
8. Health Emergencies and Preparedness, and International Health Regulations
Health Emergency Response
• Strengthen channels for the mobilization of diagnostic samples, reference materials, and human resources during outbreaks and viral emergencies requiring international assistance.
• Ensure communication is established between PAHO and WHO to support the pandemic response and utilize CC capabilities to provide needed solutions.
<< BACK TO
5.2 SPECIFIC TECHNICAL AREA RECOMMENDATIONS
